All-on-4 concept vs traditional implant placement methods with 25 years experience and over 28,000 dental implants placed
University Munster, Germany
: Dent Health Curr Res
Objective: The purpose of this lecture is to examine the incidence rate of early and late failure of dental implants and associated prosthetic problems with reference to a total number of 28,000 implants placed between 1992-2018 in patients requiring partial and full-arch rehabilitation. We have compared the nowadays popular and cost-effective all-on-4 all-on-6 rehabilitation solution with 8-10 implants placed in the maxilla, and 6-8 in the mandible. Results: Following the adaptation of various dental implant systems, our retrospective study shows that the rate of late implant failure and the associated prosthetic problems were lower in case of increased number of implants. We suggest that the result is due to the balanced distribution of the functional load on the implant and bone, the improved stress distribution against the opening force of the mandible and the overload of posterior implants. Conclusion: The benefits of the all-on-4 and all-on-6 rehabilitation solution include that (the sometimes risky) bone grafting in the posterior mandible can be avoided, furthermore, the increased inter implant distance ensures improved blood supply. However, excessive overloading of the implants may lead to screw fracture, prosthetic fracture and bone loss. In case of unexpected complications, the increased number of patient visits make the cost-effective all-on-4, all-on-6 treatment concept a subject to controversy. When comparing the risks and complications of the all-on-4, all-on-6 rehabilitation solution with posterior mandibular bone grafting procedures, we can find similar results.
Attila Kaman has completed his degree at University of Medical Sciences Medical and Dental faculty named after Semmelweiss, and postdoctoral studies, MSc- Master of Science of Implantology at University Munster, Germany. He is the chief surgeon of the Implantcenter Dental and Maxillofacial Clinic in Budapest. He is leading and maintaining 6 clinics in 4 countries (London, Geneve, Bern, Zurich/ Kloten, Budapest, Dublin). He is the chairman of association of Leading Hungarian Dental Clinics.